scholarly journals Lean Mass Improvement from Nutrition Education and Protein Supplementation among Rural Indian Women Living with HIV/AIDS: Results from Cluster Randomized Factorial Trial at 18-Month Follow-Up

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 179
Author(s):  
Catherine L. Carpenter ◽  
Kavita Kapur ◽  
Padma Ramakrishna ◽  
Suresh Pamujula ◽  
Kartik Yadav ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Lean Mass ◽  
Andhra Pradesh ◽  
Protein Supplementation ◽  
Women Living With Hiv ◽  
Factorial Trial ◽  
Cluster Randomized ◽  
Living With Hiv ◽  
Hiv Aids

Loss of lean muscle mass impairs immunity and increases mortality risk among individuals with HIV/AIDS. We evaluated the relative contributions of protein supplementation and nutrition education on body composition among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. We conducted a cluster randomized controlled 2 × 2 factorial trial lasting six months with follow up at twelve and eighteen months. Interventions occurred in the Nellore and Prakasam regions of Andhra Pradesh by trained village women, ASHA (Accredited Social Health Activists), and included: (1) the usual supportive care from ASHA (UC); (2) UC plus nutrition education (NE); (3) UC plus nutritional protein supplementation (NS); (4) combined UC plus NE plus NS. A Bioimpedance Analyzer Model 310e measured body composition. SAS 9.4 analyzed all data. Mixed models using repeated measures evaluated lean mass change from baseline as primary and fat weight and total weight as secondary outcomes. Lean mass change was significantly associated with NS (p = 0.0001), NE (p = 0.0001), and combined NS plus NE (p = 0.0001), with similar associations for secondary outcomes. Stronger associations for total weight were observed with greater ART adherence. Nutritional interventions may improve physiologic response to HIV. Significant increases in lean mass resulted from independent and combined protein supplementation and nutrition education.

scholarly journals Body Composition Changes Resulting from Nutrition Supplementation and Nutrition Education: Results from 2 × 2 Factorial Trial of 600 Rural Indian Women Living with HIV/AIDS

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 818-818
Author(s):  
Catherine Carpenter ◽  
Kavita Kapur ◽  
Padma Ramakrishna ◽  
Kartik Yadav ◽  
Maria Ekstrand ◽  
...  
Keyword(s):  
Body Composition ◽  
Nutrition Education ◽  
Muscle Mass ◽  
Women Living With Hiv ◽  
Nutrition Supplementation ◽  
Increased Risk ◽  
Factorial Trial ◽  
Cluster Randomized ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Objectives People living with HIV/AIDS are at increased risk of nutritional deficiencies. Loss of lean muscle mass has been associated with a more rapid decline of immune function and increased risk of mortality among individuals suffering from HIV. Our objectives were to evaluate the relative contributions of nutrition supplementation and nutrition education on body composition outcomes using a cluster randomized factorial trial among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. Methods We conducted a prospective cluster randomized controlled 2 × 2 factorial design to assess impacts of nutritional education and nutritional supplementation over a six-month period, with follow up at six, twelve and eighteen months post enrollment. Study protocols were approved by Human Subjects Committees at the Universities of California at Los Angeles, Irvine, and San Francisco and the Ministry of Health in India. Interventions were delivered in the Nellore and Prakasam regions of Andhra Pradesh by trained lay village women, Ashas (Accredited Social Health Activists). Interventions included: usual supportive care provided by Ashas; 2) Asha Support plus Nutrition education; 3) Asha support plus Nutrition supplementation; and, 4) Asha support plus Nutrition education plus Nutrition supplementation. We measured body composition using a Bioimpedance Analyzer Model 310e. All data was analyzed using SAS 9.4. Results Mixed models evaluated change in lean muscle mass from baseline as the primary outcome, and fat weight, overall weight and BMI changes as secondary outcomes. Change in muscle mass from baseline was significantly associated with nutrition supplementation (P = 0.001), nutrition education (P = 0.01), with a significant interaction (P = 0.03) for the combined nutrition supplementation and education term. Using the same factorial structure, nutrition supplementation and education were independently associated with changes in BMI and fat mass. Conclusions Interventions that target nutrition may be an important approach to improving the physiologic response to HIV. We observed significant increases in muscle mass resulting from independent contributions of nutrition education and nutrition supplementation, as well as their combined contribution. Funding Sources NIMH R01MH098728.

scholarly journals Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study

2018 ◽  
Vol 17 ◽  
pp. 232595821877376
Author(s):  
Benissa E. Salem ◽  
Yvita Bustos ◽  
Chidyaonga Shalita ◽  
Jordan Kwon ◽  
Padma Ramakrishnan ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Qualitative Study ◽  
Health Care Access ◽  
Rural Women ◽  
Andhra Pradesh ◽  
Self Management ◽  
Structural Level ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.

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